Successful treatment of bleeding ileal varices by double-balloon enteroscopy and cyanoacrylate injection (with video)

摘要

A 73-year-old woman with a history of alcoholic cirrhosis was transferred to our medical center because of ongoing bright red blood per rectum. Before transfer, she underwent 2 EGDs, 2 colonoscopies, 1 tagged red blood cell bleeding scan, and mesenteric angiography with no demonstrated source of bleeding. She required 17 blood transfusions in -1 week. A repeat bleeding scan showed possible bleeding in the distal small bowel. Retrograde double-balloon en-teroscopy identified a large ileal varix with stigmata of recent hemorrhage approximately 150 cm proximal to the ileocecal valve. This was injected with 2 mL of cyanoacrylate with resolution of the bleeding. There was no recurrence after 6 months of follow-up.